NPIMap

Organization Active NPI

Yakima Valley Farm Workers Clinic

  • Federally Qualified Health Center (FQHC)
  • Spokane, WA
National Provider Identifier
1922051978
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
YAKIMA VALLEY FARM WORKERS CLINIC
Practice address
120 W Mission Ave
Spokane, WA 99201-2315
Phone
(509) 326-4343
Fax
(509) 326-4289
NPI assigned
May 19, 2006
Organization subpart
Yes
Parent organization
YAKIMA VALLEY FARM WORKERS CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Juan Carlos Olivares, CEO
Title
Executive Director
Phone
(509) 865-6175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

120 W Mission Ave
Spokane, WA 99201-2315

Mailing address

PO Box 190
Toppenish, WA 98948-0190
Phone (509) 326-4343

Other identifiers 2

IdentifierTypeStateIssuer
7107915MedicaidWA
30820OtherWALABOR AND INDUSTRIES

Other names 1

  • Spokane Falls Family Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040211000663 WA Part B Supplier - Clinic/Group Practice 4385541986 Receives reassigned benefits from 321 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wapato, WA; Yakima, WA; Ellensburg, WA; Toppenish, WA; Grandview, WA; Granger, WA; Kennewick, WA; Pasco, WA…
O20100823000081 WA Part A Provider - Federally Qualified Health Center (FQHC) 4385541986 Practice locations: Spokane, WA

Federally qualified health center certification: CCN 501860

Legal name
YAKIMA VALLEY FARM WORKERS CLINIC
Doing business as
UNIFY COMMUNITY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 1, 2001
Last certification
Sep 1, 2001
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Jan 1, 1978 in WA
Enrollment address
120 West Mission Avenue
Spokane, WA 99201-2322

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

National Provider Directory

National Provider Directory
Part of
Milton Freewater Medica

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Sandra April Individual Corporate Director Nov 1, 2001
Thomas Sak Individual Corporate Director Nov 1, 2001
Jose Alberto Nunez Individual Corporate Director Nov 1, 2001
Lorenzo Cuevas Individual Corporate Director Nov 1, 2001
Virginia Santillanes Individual Corporate Director Nov 1, 2001
Sheila Robertson Individual Corporate OfficerBilling Supervisor Jan 1, 2020
W-2 Managing EmployeeBilling Supervisor Jan 1, 2020
Irene Taylor Individual Corporate DirectorBoard Member Aug 1, 2019
Martin Torres Individual Corporate Director Nov 1, 2001
Alfredo Aceves Individual Corporate Director Nov 1, 2001
Christine Trotter Individual Corporate OfficerCeo Feb 17, 2020
W-2 Managing EmployeeCeo Feb 17, 2020
Roberto Alvizo Individual Corporate DirectorBoard Member Jan 1, 2014
Patricia Myers Individual Corporate Director Nov 1, 2001
Adrian Ochoa Individual Corporate DirectorBoard Member May 1, 2021

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lancaster Family Health Center at LancasterSalem, OR, CCN 381971 Federally qualified health center Operational/Managerial Control Jan 9, 2017
Coastal Family Health CenterAstoria, OR, CCN 931016 Federally qualified health center Operational/Managerial Control Mar 1, 2017
Miramar Health Center KennewickKennewick, WA, CCN 941124 Federally qualified health center Operational/Managerial Control Mar 25, 2021

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1922051978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989480190",
            "telephone_number": "509-326-4343",
            "fax_number": "509-326-4289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W MISSION AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012315",
            "telephone_number": "509-326-4343",
            "fax_number": "509-326-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAKIMA VALLEY FARM WORKERS CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YAKIMA VALLEY FARM WORKERS CLINIC",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "OLIVARES",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "CARLOS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "509-865-6175",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7107915",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "30820",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spokane Falls Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.